Rapid Recovery with an Effective Therapist: A Comment on Hansen, Lambert, and Vlass

Abstract

The person of the therapist is a robust predictor of psychotherapy outcome (Wampold & Imel, 2015). Additionally, some clients make rapid improvements, or sudden gains, in therapy and little is known about the mechanisms underlying this process. In the target article Hansen, Lambert, and Vlass (2015) explore the interaction between these two facets of psychotherapy and discuss how one therapist was able to obtain sudden gains with a high percentage of her clinical caseload. In our comment, we discuss aspects of the therapist who was the focus of the Hansen et al. that we believe contributed to her status as an effective therapist. Furthermore, we discuss the sudden gains obtained by the therapist in Hansen et al., review these improvements within the context of the larger body of evidence and suggest that both case mix as well as therapist skills played a significant role in the exceptional outcomes.